# ROBERTO D LOPEZ

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ledus Pedorthic Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1598937047
- **Authorized official:** MR. ROBERTO DANIEL LOPEZ C. PED., CFO (OWNER)
- **Authorized official phone:** (760) 352-3336

## Contact information

- **Practice address:** 496 W MAIN ST, EL CENTRO, CA 92243-3019
- **Practice address phone:** (760) 352-3336
- **Practice address fax:** (760) 352-3271
- **Mailing address:** 496 W. MAIN ST, EL CENTRO, CA 92243-3012
- **Mailing address phone:** (760) 352-3336
- **Mailing address fax:** (760) 352-3271

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 45656 | CA | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | — | NULL | — |

## Other

- **Enumeration date:** 03/25/2008
- **Last updated:** 06/21/2017